301 people charged in record $900M Medicare fraud scheme

The Department of Justice charged 301 people, including doctors and nurses, over alleged crimes related to a nationwide $900 million Medicare false billing scheme.

The investigation was led by the Medicare Fraud Strike Force and resulted in criminal and civil charges against 301 people, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in healthcare fraud schemes. Medicare and Medicaid is suspending payment to a number of providers under the authority of the Affordable Care Act.

The Justice Department said the coordinated takedown is the largest in the history of the strike force in terms of the number of defendants charged and loss amount.

Defendants face charges including conspiracy to commit healthcare fraud, violations of anti-kickback statutes, money laundering and aggravated identity theft. False billing was carried out in different medical treatments and therapies such as home healthcare, psychotherapy, physical and occupational therapy, durable medical equipment, and prescription drugs

More than 60 defendants are charged with fraud related to the Part D Medicare program — the fastest-growing prescription drug program in Medicare.

“As this takedown should make clear, health care fraud is not an abstract violation or benign offense. It is a serious crime,” Attorney General Loretta Lynch said in a statement. “The wrongdoers that we pursue in these operations seek to use public funds for private enrichment. They target real people — many of them in need of significant medical care. They promise effective cures and therapies, but they provide none. Above all, they abuse basic bonds of trust — between doctor and patient; between pharmacist and doctor; between taxpayer and government — and pervert them to their own ends.”

The defendants allegedly carried out schemes to submit claims to Medicare and Medicaid for treatments that were unnecessary and often never provided. Many defendants were paid in cash kickbacks as part of the alleged conspiracy to illicitly charge for Medicare services.